Neurolysis of the Greater Occipital Nerve
in Cervicogenic Headache: A Follow up Study

This section is compiled by Frank M. Painter, D.C.
Send all comments or additions to:    Frankp@chiro.org

FROM:   Headache 1992 (Apr); 32 (4): 175–179

Bovim G, Fredriksen TA, Stolt-Nielsen A, Sjaastad O

Department of Neurology,
Regionsykehuset, Trondheim University Hospital, Norway

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Entrapment of the greater occipital nerve (GON) in its peripheral course has been thought to be of possible pathogenic significance in cervicogenic headache. We have performed a "liberation" operation ("neurolysis") of the nerve in the nuchal musculature, with special attention to the trapezius insertion, and the follow-up results in 50 patients are presented. The immediate effect of the operation was quite good, but the pain gradually recurred in the majority (46/50) of the patients. Eventually, all operated patients will probably have recurrence of pain episodes.

Nevertheless, most patients claim that the overall disability is less after the operation, and 40% actually want to undergo a new, identical procedure. The justification for doing a second "liberation" operation is clearly less than for a first operation. In our opinion, this operation should not be performed in patients with cervicogenic headache in general. The present study shows that other therapeutic approaches should be searched for in cervicogenic headache.

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